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JRP1120, RN 6,187 Views

Joined: Apr 26, '11; Posts: 160 (36% Liked) ; Likes: 138

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  • Oct 30 '12

    I was at my workplace earlier this month when my supervisor told me about a volatile situation that was unfolding on a different floor between another nurse and a verbally abusive family member. This particular family member was at the bedside for twelve hours straight and refused to leave when gently prompted. She was confrontational, hollering, taking pictures with her cellular phone, and interfering with procedures that needed to be performed on the patient. Nothing seemed to please her.

    And guess what? The verbally abusive family member was coddled by management and allowed to stay well beyond the visiting hours that other visitors are expected to follow. I suppose the old saying applies in this situation: "The squeaky wheel gets the grease." Too many members of the public know that they can act like loudmouthed fools, behave disrespectfully toward nursing staff, and basically get away with it.

    I clearly recall another instance of blatant disrespect at the same workplace. A group of surly family members were yelling obscenities and threats at the floor nurse and supervisor after being informed that the patient contracted a urinary tract infection: "You haven't seen crazy until you've seen me!" "I will put my foot up your ass!" "You'd better get my mother out of this place before I get you out of the way!" To keep a long story short, the patient was sent to another hospital to receive the same intravenous antibiotics that my workplace had been providing.

    These same instances of disrespect would be totally nipped in the bud at other places of business. For instance, the frustrated traveler who attempts to enter the cockpit and give the airline pilot a 'piece of his mind' will be jumped on by the air marshall. If I start acting out irrationally and refuse to leave the local new car dealership once closing time has arrived, the workers will call law enforcement to physically force me off the property. The customer who threatens the safety of the teller at the credit union will be escorted to the parking lot by security guards. If any of you try to walk to the back of the bakery to harass the staff and take pictures of the employees and equipment with your cell phone, you will not be in the bakery for very long.

    According to polls, nursing is the most trusted profession. For the 12th year, nurses were voted the most trusted profession in America in Gallup's annual survey that ranks professions based on their honesty and ethical standards (American Nurses Association, 2012). However, trust must not be confused with respect. While nurses are certainly trusted, we are not respected by the public, management, or administration.

    Although it is generally not constructive to babble about a problem without offering possible resolutions, I do not pretend to know of any solutions to this complex problem. For starters, it would be nice if we had the backing of management more often. Do you have any real life tales of disrespect from patients, visitors, families, or other members of the public? If the answer if yes, please share. And most importantly, please stay safe!

  • Oct 30 '12

    Reading through these topics it sounds as if a lot of nurses are working under terrible hospital environments. It makes me realize how lucky I am to work where I do.

    I'm an RN on an inpatient psychiatric unit. I have a supportive manager and great co workers. Sure it's not perfect but we really are a team that respects each other and works well together. This includes nurses, psychiatrists, social workers, RT and pastoral care. Most of us have been on the same unit 20-30 years. Staffing is adequate and if acuity is high every step is made to get extra help. We have each others backs and more importantly want the best for our patients. We are good at what we do!

    Upper management also has support for the nursing staff. While money and customer service are at the top of their list; it's not at the expense of nurses. Our safety is important. At a recent mandatory in service day it was stressed that any threat from family/patients will not be tolerated. We were instructed to call security and fill out work place violence forms. Of course on our unit this has always been a top priority; it is now being stressed everywhere. When I was assaulted by a patient and off work 5 months, my facility stayed behind me.

    I just felt the need to point out that there are good places to work. Places where you do feel valued and like you are making a difference. Places where your skills, compassion, desire to help, all the reasons you became a nurse, can be utilized at high potential!

  • Oct 30 '12

    Hi all,

    When I first got out of nursing school 15 years ago I received my first job at a nursing home. I was called all sorts of names by my preceptor. Incompetent, stupid. I'd leave the orientation crying..

    I stuck it out for a year. Even after orientation the other seasoned nurses were just MEAN. Over worked probably played into the equation. But perhaps there wouldn't be such a revolving door if nurses were NICER. I just always felt stupid. If I asked for help, a nurse would tell me I should know it already and just curse me out and I got to the point I didn't want to ask for any help...Heck, I was scared to say good morning to most of my coworkers.

    One Christmas I came into the nursing home to find out the 5 other nurses were "sick". (there were 3 floors, 2 nurses to a floor). 50 residents EACH floor. I cried the whole shift. I remember calling MY DON, and she was telling me that agency nurses were coming. They didn't show up until an hour before my shift ended.

    I left there and for the past 14 years-I got a nice cushy job at a methadone clinic. This pretty much means my skills got rusty while I dished out methadone from 6a-3p. I had great hours,(great for me since I am a morning person)great pay, actually got to sit down and use the bathroom when I wanted, and was pretty complacent. What I should have been doing is done some floor nursing on the weekends, and been prepared for when funding was cut to the clinic.

    And then the clinic was closed. 15 yr Lpn with basically no skills. SCARY. It was either pay my bills or go out in the street. I had to relearn. I couldn't be scared even though I was. I wondered if I would feel stupid and incompetent like last time.

    Well, I applied to a different nursing home and my experience was VERY different than last time. I let her know I had worked methadone and was VERY rusty. At first I thought she'd give me a hard time, especially being an LPN for so long and yet being so rusty. I had my tissues ready for when I would cry afterwards. Didn't need them. Actually she WAS SO Patient. SO NICE.

    I fell in love with bedside nursing again.

    All the skills I was afraid of? I felt like a VERY different nurse the 2nd time around. Soon I was running circles around the other nurses.

    Well, I am now doing home health nursing dealing with primarily vent dependent patients every other wekend(if you had told me I'd be doing this 2 years ago I wouldn't have believed it!) and doing my nursing home gig M-F. LOVE IT! LOVE IT!

    What a difference a kind nurse preceptor makes! Sometimes the administrators at the nursing home get on my nerves..but this time i get along with my nursing coworkers, unlike last time. That makes all the difference to me.

    Well, at the home health nursing agency I also work at- they sent me to a new assignment a few months ago. Patient had round the clock nursing and also a round the clock nurses aide.

    While I was working I found out the aide that was working with me, the aide I was delegating duties to - was an RN.

    I wanted to know why was she working as an aide (under me!) when she could be working as an RN??!!

    She told me she graduated a year ago, and felt incompetent. Cried every time she went to the hospital because other nurses would yell at her.

    She said she decided to work as an aide to feel more comfortable. But still, she felt horrible. Her self confidence was torn down.

    I saw myself in her. And i realized this was one less nurse on the work schedule so that the rest of us really have to bust our ****!

    So I let her observe me doing things, talking to her about why I did so and so,etc. without tearing her down.

    She now left work as an aide and is working as an RN. I hope she remembers me...she may be my boss one day!

  • Oct 25 '12

    I remember having this debate with other students while I was in school. I have seen nothing during my time practicing nursing to change my mind about the issue. Now, with the recession bringing out the true colors of nurses and everyone around them, my opinion seems even more valid. I wonder what others think about it.

    I remember sitting in nursing school as the instructor drummed on and on about how "Nursing is a profession." That exact theme butted it's head into almost every single class one way or another, regardless of the subject matter. I often found myself thinking "Who cares?" or "What's the point in that?". Then came the dreaded "Dimensions of Nursing" class. It was the class all RN's must go through at one point or another (IDK if LPNs do or not). There are other names for it "Political Aspects of Nursing" I've heard among a few others. It is the class in which you must discuss the political issues that involve nursing. You are encouraged to join this and that group, Nursing as a Profession is discussed over and over, and you must do a research paper. I never really said in that class how I really felt about the whole business of nursing being a profession in fear of drawing the ire of my superiors.

    What is it I had to say that my fellow students got to hear during breaks that my instructors did not? Well: Nursing is not a profession, not even with a very generous stretch. It is a labor, a trade. We are judged solely by the amt. of patients we can handle and still keep the minimal quality expected by our administration up to par. Not very much unlike a McDonald's burger flipper. The faster you can cook those patties without screwing too many up, the better you are. That's all there is to it really. If you don't believe me, take a gander at where nursing expenses falls in the budget. We are not logged next to the admin./doctors/lawyers or any of the other professionals. We are grouped in with dietary/housekeeping/security. As far as budget makers are concerned (and, lets be honest, they make the rules), we are a debt, like a labor.


    Ever see the movie "Man in the Iron Mask"? The King/spoiled twin tells his brother "Into the dungeon you will go, and you will wear this mask again, and you will wear it until you love it."

    We are wearing the mask, but are for some reason we are unable to learn to love it. So we will forever stay in the dungeon denying what we are.

    Lets face it. All the aspects of a "profession" are an illusion in nursing.

    Definition of a profession:
    A profession has a unique body of knowledge and values – and a perspective to go with it.
    A profession has controlled entry to the group eg registration
    A profession demonstrates a high degree of autonomous practice.
    A profession has its own disciplinary system.
    A profession enjoys the Recognition and Respect of the wider community.

    1. Unique body of knowledge: We do need to go to school and must learn a lot, but I don't know about the unique part of it. Most CNA's pick up on how to do what we do after just a couple years, without the schooling. As far as values and perspective go, lets face it, we can't even agree in here on what that is. How many "Calling from God vs. Its a job" threads/rants have you seen on this site. I've lost count. We can't even agree amongst ourselves what degree we should have. I've also lost count of the "BSN vs. ADN vs. Masters" threads.

    2. Controlled entry: Phfffft. It is controlled, but not by us. The hospital/medical field administration decides this. Whatever they decide they are willing to hire is what the rule is. If they decide tomorrow to never again hire ADNs.........that's that for them. We have no say in it. Seen any "Nurses eat their young" vents/threads lately. I know you have, even if you were a blind, deaf mute with both hands tied behind your back you can't help but run into them on here. If we truly were in control of who came into the profession, such threads would be minimal. Can't be angry about who is allowed in when its your decision who gets in.

    3. Demonstrates a high degree of autonomy: Again, I lead with PHfffffft. Our job description continues to be and will forever be everything and anything they can't pawn off on the other laborers. How many of us, since the recession hit, have been told to pick it up and help out in non-nursing job related ways? Empty the trash, stock the cabinets, hand out trays, collect and clean the trays..........its endless. We are unable to define for ourselves what we will and will not do. You don't see them sending the Legal dept. any emails about helping maintenance do you? Any rules/laws concerning scope of practice are simply to protect patients from us should we decide to play doctor. No laws exist to restrict what can be expected of us away from the bedside (no, that would actually be useful, help the pt., can't do anything silly like that).

    4. Has its own disciplinary system: Do I need to insert Phffffft again? Oh, I just did. We only qualify here if badgering, cattiness and petty write ups are "disciplinary". Nuff said.

    5. Respect of the community: I'll resist the urge to insert the obvious lead here. I'll just point out the complaining about surveys that's been the norm lately. Lets face it folks, professions who have respect are not surveyed like this. These surveys resemble grade school report cards "Nursey doesn't play well with others". If we were "respected", we'd be the ones filling out the surveys on how to improve the model of care given.

    Think back to your highschool days. Remember that class clown who tried way too hard to be funny? The not so good looking girl who never stopped digging for compliments on her looks? The not so well liked guy always asking if you and he were buddies or not? That's what nursing has let itself become. Constantly running around worrying about impressing people and all the while completely losing its focus on the primary goal. A lost teenager suffering from an inferiority complex.

    Maybe if we embrace the fact that we are............gasp..............a mere labor, we will be able to dedicate ourselves to our patients. Instead of worrying about proving nursing holds a "unique body of knowledge" and making up useless, pointless "theories" and such (tell me one instance you have found a use for nursing diagnosis), we will become more useful. Focus instead on better time management, better understanding of the things we actually use on the job (the equipment for instance) and a better understanding of the tasks expected of us (study IV insertion in school instead of writing papers about why nursing is a profession).

    I know many of you will be upset with me and my views. They are what they are. I make no apologies for them. Not having a well liked opinion has never stopped me from saying what I feel needs said before. I wrong? Why?

  • Oct 25 '12

    Not to put too fine a point on things, but......sometimes, nursing really bites.

    It bites when you've built a life and a reputation on what you can do with a stethoscope and a nose for the subtlest signs of trouble, and some corporate pooh-bah tells you that your job is on the line---not because you're doing a lousy job caring for your patients, but because you haven't completed enough forms on them to make the Sierra Club call for your head on a recycled glass platter.

    It also bites when you have no control over patients' family the phlebotomist who thinks she's an RN and will loudly declare to the entire floor that you're the worst nurse on the planet and she's having her Auntie moved RIGHT NOW. You know how a lot of nurses take medication for depression or anxiety? I take medication to keep me from slapping stupid people and blaming it on the side effects.

    Speaking of depression and anxiety: I wish someone would do a definitive study on how many nurses do take meds for these stress-related conditions. I'd bet a month's salary that a very large minority of nurses have at least a half-empty bottle of Xanax in their medicine cabinets, which, by the way, is actually not a good place to store meds. (The shelf above the refrigerator is where most of mine live...well, except for the metformin, which I forget to take at dinner if it's not on the dining-room table.)

    Then there are the silly, amusing, and downright hilarious things that happen in nursing that make it worth NOT drop-kicking the idiots through the goalposts of life (and losing your license in the bargain). Have you ever seen a nurse or aide who can't be bothered to bend over and pick up a used Band-aid off the floor, yet can perform a perfect head-first dive behind the med refrigerator to find the pack of cigarettes she dropped behind it? And you've got to love working the postpartum floor and trying diplomatically to convince a 19-year-old primip to name her new daughter something less apt than "Meadowlark Sunshine" to induce hatred in that same child in the within five minutes of starting first grade.

    You also have to hand it to the average nurse manager, whose title tends to reflect her/his distance from the bedside. They just don't get enough credit for their contributions to our profession. Yes, I'm a nursing director myself, and no, I haven't worked a floor shift in over two years; but when you get to the upper echelons, the titles grow more pompous......and the cluelessness is increased exponentially.

    Take the person above me on the food chain: she is known as the Regional Director of Clinical Operations. She's a good egg, though, and I'd never talk smack about her, whether here or anywhere else. But if you go above her, you run into the Vice President of Clinical Operations, then the grand-nurse of them all, the National Director of Clinical Operations and Health Services. I've never even met the National Director of Clinical Operations and Health Services. For that matter, I don't really know for sure that she exists. But I'm not taking any chances.

    Just a few odd musings on a wet, windy night somewhere in the Pacific Northwest. Which reminds me: have you ever driven to work in the rain........while drinking coffee.....forgetting that you just took 80 mg of Lasix......and then stepped into a puddle upon disembarking? Me neither. Until today. Thank Heaven for the change of clothes I keep in the trunk "just in case".......

  • Oct 13 '12

    Last time I booked off well in advance, and was told 3 days before hand that "well... we couldn't really find anyone who wants to cover"... I forwarded her a copy of the approval email she had sent me 3 months prior, and added that she'd also need to pay me for my non-refundable concert tickets, non-refundable air tickets, and the (probably non-refundable) 2 nights hotel reservations... cash in hand BEFORE the time I would have left. I also CC'd it to her boss, and HR.

    I didn't miss the concert.

  • Oct 13 '12

    It's the manager's responsibility to staff accordingly. If your vacation was approved there's nothing he can do about. I don't care if we're short staffed. Not my problem. His problem. Its called being a manager. Reason 628 out of 1000 why all nurses need a union.

  • Oct 13 '12

    Don't you love it when you book months in advance for a vacation or a holiday break, you have approval from your manager, and appropriate time off - ONLY to have your manager later state that you might not be able to take your vacation or visit with your family.

    My rule: If I dropped money on it, I AM GOING. TOUGH KADODDLES!

    If staffing and scheduling is such a problem, perhaps you could have told me that 6 months ago!!! . You also should have hired those 5 RNs you interviewed last month (like any reasonably competant manager would do).

    You should have also not lied to me by saying "Take your vacation, we will be staffed"

    I booked a Christmas vacation with my family - 3,000 miles away.

    Regardless of what you say or imply or threaten - I AM GOING HOME FOR CHRISTMAS WITH FAMILY.

    You keep threatening me about my 1-time SEVEN DAY vacation, but you seem to jet set 4 times a year to Europe and expect me to swallow that pill.

  • Oct 6 '12

    Hmmmmm....sounds like the honey moon is officially over.

    What you are going through is very, very common especially in any high impact job. For the most part, it is considered a portion of growing pains and will pass as your skin toughens and time/people management becomes more second nature.

    I believe the others above have a good point on deciding what you wish to accomplish as a long term goal and then structuring your current practices to match.

    However, my advice is a touch different:

    First, give yourself a bit of time to work through this period. Reality is a kick in the pants and most of us end up more than a little stressed and bitter before appropriate coping can set in.

    Second, should point number one be deemed unacceptable, update your resume and have it ready to go. In fact, go ahead and begin your job search now so you can take your time to find something that is more fitting if it will end up benefiting your long term goals. In the meanwhile, keep working as you are so you are continuing to build experience and bring home a paycheck. Yay for money.

    Third, work on filtering the drama and bull crap, i.e. reduce your mental clutter. I find that I can deal with most anything provided I keep myself from getting sucked into the unnecessary horse-hockey that is going on around me. I have various tactics I employ: from wearing ear buds and listening to relaxing music when I take lunch, to walking away from conversations at nursing stations that have nothing to do with anything pertinent to my patient, to verbally declaring the three foot area around me a "drama free zone" with the looming threat of a beating with a slab of smoked salmon as the punishment to any would be offenders. And when in doubt, ignore it. Just let it go.

    On a different note, do you have vacation time? Sounds to me like someone could use some time in the sun being waited on by well-oiled cabana boys touting margaritas and chips. Even without vacation time, be sure you are taking care of you when you are off. Set aside time on a weekend or, my personal favorite, one night a week is my night to spoil myself rotten. I prepare my favorite meal, sip my favorite wine (or tea, depending), take an uber long shower and use special yummy smelly shampoo, watch shows that I love or rent a movie I've been wanting to see. When my foot is not busticated, I work out first or practice some yoga and just, in general, give myself a night of indulgence.

    As my dear friend L'Oreal says, "Because you're worth it."

  • Oct 6 '12

    I. LOVE. Nursing school.

    There. I said it.

    No, the NCLEX style questions aren't awesome. But they make you think! And when you learn the rationale behind the answer you should have picked, you learn how to be a better critical thinker. I actually LIKE that!

    I've also decided I'm a B student in nursing school. I am okay with that. I have kids. I have responsibilities beyond school. I can only dedicate so much of my attention to nursing school. But I'm okay with it! I have Bs in my classes right now and that's just fine by me!

    My school has a super interactive curriculum and I feel like if you don't learn it, you must have just slept through it completely because what we learn in theory is reinforced in practice. The assignments might get overwhelming some days, but we learn from them. Maybe it seems crazy to write up a teaching plan on one drug, but you now know about that drug and how to think through a teaching plan. There is a difference between learning how to do a teaching plan, and actually doing one.

    Our clinicals will finally be taking us to the hospital the week after this coming week. So far we've just done skills and a senior center experience. Maybe my first semester excitement is giving me a premature boost in enthusiasm for the program, but we're halfway through the semester and I find myself excited that we still have 7 weeks left. I love learning. I love my instructors (even when we don't see eye to eye).

    Yup. I'm one of THOSE people.

  • Oct 6 '12

    It depends on who says it and how they say it. If its a 90 year old little old woman I smile and say thanks. If it's a co-worker or supervisor, I politely but firmly remind them that I am capable of doing my job, and that any implication otherwise is discrimination and I will not stand for it.

  • Oct 6 '12

    If you look younger than your years, I hate to say, you'll probably be dealing with this for a long time. I am in my early 40's and people tend to think I'm in my late 20's. I think its because I am very short. People have asked my age. I smile and say, well my oldest child is 20....and I wasn't a teen mom. They do the math and realize the youngest I can be is 40. I love the look of shock on their faces. I've never had anyone really have a problem with me or my work due to looking younger.

    I know its hard (I've been dealing with it forever) but try not to let them get to you. Just prove to them you are 100% capable of doing your job and they tend to feel more at ease. You'll embrace the 'compliment' when you are older

  • Oct 6 '12

    I have been getting this since I started as a tech at age 20 or 21...people thinking I'm a teenager. I'm now 28 and people still say I don't look old enough to be a nurse. I just smile and say, "I'm not as young as I look." And move on. It's not really been a problem for me... Just assert yourself and don't be self conscious about it

  • Oct 6 '12

    There are people who will give you guff about being too young to do any job. Don't sweat it. I'm a newer nurse, but I have always looked young. I'm 40 now and the mid-twenties crowd think I'm their age. I'm sure I'll appreciate this trait when I'm in my 60s.

  • Oct 6 '12

    This is now my new favorite thread.

    Quote from hiddencatRN
    We have a place to chart narratives everywhere I've worked. "Patient updated on plan of care, given meal tray, ate pills off floor at own insistence. Family at bedside."
    My note would then continue: "Educated patient that she should not continue to eat pills off of the floor. Informed patient that nursing staff would not purposefully administer oral meds via the floor. Patient voiced understanding. Educated patient to not lick doorknobs. Informed her of the risk of mouth MRSA. Patient also educated not to lick faucets, toilets or friends' oozing pustules. Continued to educate patient on the risks of mouth MRSA. Informed patient that after touching friends' oozing pustules that she should wash her hands prior to putting fingers in mouth. Informed patient regarding hospital policy to deliver meals on trays rather than on floor. Patient will likely need further education regarding risk of mouth MRSA. At this time, patient does not appear to be open to education on mouth MSSA. Hospital system approved "Things to not lick while you're in the hospital!" handout provided to patient with relevant passages highlighted. Patient voices ability to read. Encouraged patient to request assistance as needed for avoiding inadvertent tongue to doorknob, toilet, floor, faucet contact."

    (For the record, I'm completely undecided if I would chart patient insisting on taking pills that fell on the floor or not. Probably would depend on my mood that day.)